The purpose of this systematic review was to determine the practice of medication disposal around the world and get insight into possible association between environmental awareness and people's behavior regarding this issue. A literature search (2005-2015) was performed to identify reports with quantitative data on disposal practices published in peer-reviewed literature. The most common method for disposal of unused medications in households is disposal in the garbage (Kuwait, United Kingdom, Lithuania, Qatar, Serbia, Ghana, Bangladesh, Malta and Saudi Arabia). The practice of flushing drugs into the sewage system still takes place in New Zealand, USA and Bangladesh. Only in Sweden and Germany, practice of returning drugs to pharmacy was practiced to a larger extent. The environmental impact of improper medication disposal is expected in countries with poorly functioning waste management schemes (Middle Eastern, Asian and African countries). Lack of the adequate information and clear instructions on proper manners of drug disposal was reported in many surveyed countries (USA, New Zealand, Bangladesh, Malta and Ireland). Clear and definite connection between knowledge about environmental detrimental effects of improper drug disposal and the preference towards disposal methods could not be established. Many respondents were generally concerned with issues of inadequate medicines discarding but the behavior regarding disposal of unused drugs often did not equate the awareness (Serbia, USA, Kuwait, Malta and UK). The current data emphasizes the global issue of improper medicine disposal, prevalent in environmentally-aware people.

Public services in Serbia, including government and health sectors, need to be more proactive about educating people on how to store and dispose medications, as well as finding a way for implementation of the law on medications wastage destruction.

Background Irregular antibiotic use, including self-medication contributes to the development of antibiotic resistance. One method of accessing antibiotic use in the community is through obtaining an in house inventory of drugs. Objective The aim of this study was to investigate the extent of storage and self-medication with antibiotics agents in households in Novi Sad, Serbia. Setting Households in Novi Sad. Method The study was performed during a 4-month period (October 2015-January 2016) using a sample of 112 households in Novi Sad, Serbia. Two trained interviewers performed the survey by visiting each household. The study consisted of making an inventory of all drugs in household and a semi-structured interview about drug use practices and perceptions. Main outcome measure Number of antibiotics obtained without prescription. Results Out of 112 surveyed households, antibiotics were encountered in 55 (49.1%). Antibiotics constituted 11.98% (92/768) of total number of drug items in households. Out of all antibiotics in households, 41 (44.57%) were not in current use, and presented left-overs from previous treatment. Antibiotics were usually acquired with prescription (67, 67.7%), while about a quarter of packages were used for self-medication-purchased at pharmacy without prescription (19, 20.65%) or obtained through friends or family member (6, 6.52%).The most commonly used antibiotics for self-medication was amoxicillin (reported indications included common cold, cough, pharyngitis and tooth-ache). Conclusion Antibiotics were present in large share of households in Novi Sad. Self-medication with antibiotics and sale of antibiotics without prescription represent an important problem in Serbia.

IntroductionAn ongoing issue of expired medications accumulating in some households is a universal problem around the world. The aim of the study was to investigate the extent and structure of expired medications in Serbian households, and to determine which therapeutic groups generated the most waste.MethodsThis was an observational, cross-sectional study conducted in households in the city of Novi Sad, Serbia. The study had been performed over 8 month period (December 2011 - July 2012) and it consisted of personal insights into the medication inventory in households.ResultsOf 1008 families, 383 agreed to participate and complete the questionnaire (38.3% response rate). In almost a half of households (44.4%), expired medications were maintained. The amount of expired medications was 402 items, corresponding to 9.2% of total medications presented in surveyed households. The majority of expired medications (64.7%) was in solid dosage (tablets, capsules, granules, lozenges), following semisolid (ointments, creams, gel, suppositories) and liquid dosage forms (drops, syrups). Expired medications in the households belonged mostly to 3 categories: antimicrobials for systemic use (16.7%), dermatological preparation (15.9%) and medications for alimentary tract and metabolism (14.2%).ConclusionsThis study revealed that there were relatively large quantities of expired medications in Serbian households, with a high prevalence of antibiotics for systemic use, anti-inflammatory and antirheumatic products, and medications for alimentary tract and metabolism.

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